Why I Oppose Texas HB 4553 – And Why You Should Too

Texas House Bill 4553, sometimes called “Malik’s Law,” proposes new documentation requirements for Licensed Midwives and Certified Professional Midwives who attend out-of-hospital births. Specifically, it would require midwives to report additional data about every planned out-of-hospital birth they attend, including:

• Whether a transport to a hospital occurred, and the reason for the transfer
• The final place of birth
• Whether there were any complications or adverse outcomes
• Information about the newborn’s condition at birth
• Specific provider identifiers for those involved in care

Supporters claim this is about accountability and safety. However, they don’t mention that all of this information is already being reported through existing systems, particularly when filing the Texas birth certificate. Midwives in Texas already provide detailed outcome data, including Apgar scores, interventions used, maternal complications, and neonatal status.

This bill forces midwives to duplicate that same information in a separate format, in a separate government database, at additional time and expense, under the implied threat of disciplinary action. It essentially says, “We don’t believe you’re being honest or thorough, so we’re going to make you say it again, louder.”

There is no evidence that this type of redundancy improves safety. It is not being required of doctors or applied to hospital-based births. It is aimed squarely at a specific subset of midwives and the families who choose them, raising serious questions about fairness, intent, and impact.

This isn’t about politics. It’s about people.

In all honesty, it doesn’t appear that HB 4553 impacts me directly. As a Certified Nurse Midwife (CNM), this bill isn’t written with my license in mind. But I’m speaking out anyway because I care about what this bill means for the midwives it targets and, more importantly, for the families who depend on them.

This legislation is aimed at Licensed Midwives (LM) and Certified Professional Midwives (CPM), two groups that serve thousands of Texas families every year. Many of these midwives work in communities where access to respectful, personalized maternity care is already limited. Now, they’re facing the threat of increased regulation that does little more than create red tape.

Let’s be clear: every time a mother or baby is hurt, or worse, dies, in the process of birth, it is a tragedy. It doesn’t matter whether it happened at home or in a hospital, under the care of a midwife or a doctor. Every loss is deeply painful, and every single one matters.

But legislation born from grief, no matter how understandable, must still be evaluated with clear eyes. And HB 4553? It may be well-intentioned, but it’s misdirected. It adds burdens, not solutions. It restricts choice, rather than improving outcomes. And it does nothing to prevent the tragedies it supposedly responds to.

This article is my way of saying: I stand with my fellow midwives, I stand with Texas families, and I stand against HB 4553.

What HB 4553 Actually Proposes

The bill would require LM and CPM midwives to submit additional documentation to the state about planned homebirths, outcomes, and client demographics, which is already captured through birth certificate paperwork and existing midwifery protocols.

On the surface, it sounds simple enough. More data means more accountability, right? But when you dig into it, the bill does not add clarity or improve safety. Instead, it duplicates information already reported through the Texas Department of State Health Services and layers on new reporting burdens with no apparent benefit to mothers or babies.

Let’s also be honest about who this bill is targeting. It doesn’t apply to hospital-based births. It doesn’t apply to doctors. It doesn’t even apply to Certified Nurse Midwives like me who practice under a different license. This bill zeroes in on Licensed Midwives (LMs) and Certified Professional Midwives (CPMs)—the very people who are often serving rural, low-income, or otherwise underserved families who have deliberately chosen an out-of-hospital birth.

It’s important to ask: Why are we creating new regulations for one group of providers when the same tragedies that sparked this legislation have occurred across all birth settings?

The Problem with Reactionary Legislation

There’s no denying the heartbreak behind this bill. It was named in memory of Malik, a baby who tragically died after a homebirth attended by a midwife. The pain of that loss is real, and I won’t pretend to understand what his family has been through. When something like that happens, of course, people want answers. Of course, they want change. That’s human.

But grief should never be the sole architect of policy. We often miss the mark when we legislate from emotion, especially from tragedy. We create laws that feel like action, but don’t solve the problems we’re facing. HB 4553 is a prime example of that.

This bill doesn’t address clinical standards. It doesn’t improve communication between hospitals and community providers. It doesn’t provide funding for better training, more research, or stronger safety nets. It simply demands more paperwork—paperwork that midwives are already buried in.

If the goal is to improve outcomes, then let’s focus on what works: collaborative care, transparency, and shared responsibility. Creating additional hoops for midwives to jump through may look like progress, but it’s a distraction from the real work that needs to be done.

The Real Impact: Who This Bill Burdens

HB 4553 does not make birth safer. It makes it harder for midwives—especially Licensed Midwives and CPMs—to do their jobs. These professionals are already held to rigorous licensing requirements, report detailed birth outcomes to the state, and navigate complex relationships with hospitals and emergency services. Adding more redundant requirements doesn’t enhance safety; it undermines trust and diverts time and energy away from client care.

This bill creates barriers, not bridges. It reinforces that out-of-hospital midwives are somehow less accountable, less competent, or more dangerous by default. That is not only false, it’s harmful. And it sends a chilling message to families who are already fighting to have their birth choices respected.

Let’s not pretend the burden stops at the provider. When you make it harder for midwives to practice, you make it harder for families to access the care they want. You restrict options for those in rural areas. You push vulnerable communities back toward systems that may have already failed them. You say, in effect, “We don’t trust you to make this choice.”

That’s not safety. That’s control. And it comes at the cost of real families’ autonomy.

What We Should Be Focusing On Instead

If lawmakers are truly interested in improving maternal and neonatal outcomes, there are far more effective ways than imposing more regulations on out-of-hospital midwives.

We need better collaboration between hospital systems and community-based providers. Too many transfers from home to hospital are met with hostility instead of teamwork, which puts everyone at risk. Instead of targeting midwives with paperwork, we should foster partnerships that allow seamless, respectful handoffs when higher-level care is needed.

We also need to invest in unbiased research that includes all birth settings. Most large-scale studies still focus on hospital data, leaving out critical insights from homebirths and birth centers. We can’t have honest conversations about risks, benefits, or best practices without accurate information.

Let’s also discuss access. If safety is the goal, then people need safe options—not mandates disguised as protections. That means funding midwifery education, supporting culturally competent care, and preserving birth center models that serve marginalized communities.

More red tape does not equal more safety. Listening, supporting, and empowering families to make informed decisions does.

A Word to the Moms Behind the Bill

To the mothers who are advocating for this legislation, I see you.

I see your grief. I see your heartbreak. And I believe that you are coming from a place of deep love and genuine concern. No parent should have to walk through the loss of a child, and it makes sense that you want to prevent others from experiencing the same pain.

But HB 4553 is not the answer.

It may feel like action, like protection. But in practice, it adds a burden without benefit. It targets people who often provide thoughtful, safe, and evidence-based care outside of the traditional system. And it risks driving skilled midwives out of practice altogether.

We can and should demand accountability when something goes wrong. But we must do it in ways guided by facts, not fear. We need policies that look at the whole picture, invite collaboration, and improve care for everyone, not just those within certain institutions.

I believe you want safer births. So do I. Let’s work toward solutions that actually get us there.

Final Thoughts: Protecting Choice Protects Us All

At the heart of this conversation is something bigger than any bill, provider, or birth setting. It is about autonomy—the right to make informed decisions about your own body, your own baby, and your own birth.

HB 4553 threatens that autonomy by quietly undermining trust in midwives and in the families who choose them. It adds paperwork without adding safety. And it reinforces a damaging message that only one kind of birth, one kind of provider, or one kind of data deserves to be seen as valid.

I am not writing this because I think every birth should happen at home, or because I think every provider is beyond scrutiny. I am writing this because people deserve options. And those options should come without unnecessary barriers, political posturing, or policies shaped more by fear than facts.

The safest birth is one that happens with full knowledge, full consent, and full support, no matter the setting.

So, no, this bill does not appear to affect me directly. But it affects the people I serve, the midwives I work alongside, and the future of birth choice in this state.

That is reason enough to speak up and say: We deserve better.

—Stay Strong!  Jaelin—

What You Can Do

If you believe in the right to informed choice in childbirth, now is the time to speak up.

HB 4553 is progressing through the Texas Legislature, and lawmakers must hear from constituents who value options over obstacles. This bill doesn’t enhance birth safety; instead, it imposes unnecessary burdens on midwives and restricts families’ access to trusted care.

Here’s how you can make your voice heard:

1. Identify Your State Representative:
   • Use the Texas Legislature’s “Who Represents Me?” tool to find your state representative and senator based on your address.
2. Contact Your Legislators:
   • Email: Reach out to your representative and senator via email. A common format for email addresses is first.last@house.texas.gov or first.last@senate.texas.gov. For example, Representative Jane Doe would be jane.doe@house.texas.gov.
   • Phone: Call their offices to express your opposition to HB 4553. Be concise and respectful, stating your position and reasons clearly.
3. Share Your Story:
   • Personal experiences can be powerful. If you’ve had a midwife-assisted birth or value the option of choosing your birth setting, share your story with your legislators to illustrate the real-world impact of this bill.
4. Spread the Word:
   • Share this article and information about HB 4553 with friends, family, and on social media. Encourage others to contact their representatives and voice their concerns.
5. Attend Public Hearings:
   • Stay informed about public hearings related to HB 4553. Testifying in person or submitting written testimony can influence legislative decisions. Monitor the Texas Legislature Online for hearing schedules and instructions on participation.

By taking these steps, you contribute to preserving the autonomy and choices of families across Texas. Let’s ensure that decisions about childbirth remain in the hands of those most affected—parents and their chosen care providers.

About the Author:

Dr. Jaelin Stickels, DPN, CNM, APRN, is a deeply passionate and highly skilled Certified Nurse Midwife, Women’s Health Nurse Practitioner, and the owner of Holistic Heritage Homebirth in Houston, Texas. With over a decade of midwife experience, Jaelin has had the privilege of helping several hundred (over 700 as of 2024…) women welcome their babies into the world. In addition to her advanced practice licensure training, she has additional advanced training in twin and breech births, making her one of only a few with these skills in her area.  Jaelin approaches every birth with expertise, compassion, and a deep respect for the birthing process.

Jaelin’s journey into midwifery began with a profound love for supporting women through the incredible experience of pregnancy, labor, and postpartum. Since 2010, she has been dedicated to walking alongside families during these transformative moments, offering guidance, support, and care tailored to each individual’s unique needs. She is a big believer in informed consent and ensures clients are given the best evidence-based information to make the best decisions for themselves and their families.

Married to her high school sweetheart, Ted (aka Chef Ted), since 1984, Jaelin is the proud mother of three grown children and the delighted grandmother of one amazing granddaughter. When she’s not assisting in births, Jaelin finds joy in going to the movies with her husband, quilting, and cherishing time with her family. Known by the other midwives in her practice (Holistic Heritage Homebirth) affectionately as the “Birth Hog,” she brings an unmatched dedication and enthusiasm to her work—no one loves birth quite like she does.

Read Jaelin’s Bio

Find out more about Jaelin’s Homebirth Practice (Holistic Heritage Homebirth) in Houston, TX